Bill would allow a year of Medicaid for new mothers, almost 1/2 of whom don't get routine care in Ky., where death rate is highest

By Melissa Patrick
Kentucky Health News

A bill that would extend Medicaid coverage to new mothers up to 12 months after giving birth passed unanimously out of the House Friday and now heads for the Senate for consideration. 

Rep. McKenzie Cantrell

House Bill 174, sponsored by Rep. McKenzie Cantrell, D-Louisville, would extend Medicaid eligibility for persons who have given birth for up to 12 months postpartum. It also requires the Cabinet for Health and Family Services to seek a Medicaid waiver to achieve this additional coverage if necessary. 

Cantrell told the House that the small addition that the bill would make to state law "is a seven-word change that can have a huge impact on women and families in our commonwealth." 

Rep. Kim Moser, R-Taylor Mill, co-sponsor of the bill, told the House that the United States is the only industrialized nation that has a consistently rising maternal mortality rate, and Kentucky's rate is the highest. 

"Kentucky has rates of maternal death that really rival Third World countries," Moser said. "We have 37.7 maternal deaths per 100,000 live births, which is the highest in the nation." 

Rep. Lisa Willner, D-Louisville, added that nationwide, 60% of pregnancy-related deaths are preventable, but in Kentucky, 80% are. Willner is chair of the House Democratic Women's Caucus, which created the Kentucky Maternal and Infant Health Project that includes a slate of bills and resolutions to improve maternal health outcomes. 

"This is one step toward preventing those complications from pregnancy," she said, "and there are many more steps we can take."

In an e-mail encouraging Kentuckians to sign a letter of support for the bill, Kentucky Voices for Health explains that the expanded coverage is possible through the American Rescue Plan Act, the pandemic relief bill Congress passed a year ago. It allows postpartum care to go from 60 days to a full year following the birth of a child for mothers with incomes up to or slightly higher than 138% of the federal poverty level. That is the limit for Medicaid coverage. 

KVH said, "This is important because about one in three pregnancy-related deaths occur one week to one year after delivery. Of those deaths, three in five are preventable and the ratios of pregnancy related deaths among people of color are up to five times higher than white birthing people."

Kentucky Youth Advocates Executive Director Terry Brooks said, "Despite the increased risk of postpartum death and illness, nearly half of women do not receive routine care after birth, regardless of whether or not they experienced complications during pregnancy. HB 174 is good news for the health and well-being of new moms and their babies."

The bill also has the support of the Kentucky Association of Health Plans, the insurance companies doing business in the state, including Medicaid managed-care companies.

“Postpartum depression affects a significant portion of new mothers, and when left untreated is one of the leading causes of pregnancy-related death. Kentucky’s Medicaid managed-care organizations are well-positioned to ramp up outreach and connect moms to supports services that can change and save lives,” KAHP Executive Director Tom Stephens said in a statement issued after the bill passed out of committee.